A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

Assess for neck vein distention

Monitor for postural hypotension

Assess blood glucose level

Monitor for an irregular heart rate

Weigh the client daily

Answer and Explanation

Correct Answer : A,C,D,E

A. Assess for neck vein distention: Neck vein distention can occur in Cushing's syndrome due to fluid retention and hypertension. It is an important sign to monitor as it can indicate complications like heart failure.

B. Monitor for postural hypotension: Clients with Cushing's syndrome typically have hypertension rather than hypotension. Therefore, postural hypotension is not a common issue to monitor for in these patients.

C. Assess blood glucose level: Hyperglycemia is common in Cushing's syndrome due to increased cortisol levels, which promote glucose production and reduce glucose uptake by cells. Monitoring blood glucose is essential to manage this condition.

D. Monitor for an irregular heart rate: Cushing's syndrome can cause electrolyte imbalances (like hypokalemia), which may lead to cardiac arrhythmias, so monitoring for an irregular heart rate is important.

E. Weigh the client daily: Daily weight monitoring helps track fluid retention, which is common in Cushing's syndrome due to cortisol-induced fluid retention. This can help in managing the client’s fluid status and detecting worsening of symptoms.

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Correct Answer is A

Explanation

A. "These tests help determine the degree of damage to the heart tissues.": Cardiac enzymes, such as troponins and creatine kinase-MB (CK-MB), are released into the blood when heart muscle is damaged. Elevated levels indicate the presence and extent of myocardial injury, helping to confirm the diagnosis of an MI.

B. "These tests will enable the provider to determine the heart structure and mobility of the heart valves.": This is incorrect; cardiac enzymes do not provide information about heart structure or valve function. An echocardiogram or other imaging studies are used for structural assessment.

C. "Cardiac enzymes assist in diagnosing the presence of pulmonary congestion.": Pulmonary congestion is not directly diagnosed with cardiac enzymes. It is typically identified through clinical assessment and imaging like chest X-rays.

D. "Cardiac enzymes will identify the location of the MI.": While cardiac enzymes confirm the presence of myocardial damage, they do not specify the exact location. The location is identified using ECG and imaging techniques.

A. Helping the client select a low-salt diet B. Encouraging the client to drink 2 to 3 L of water daily C. Maintaining a semi-Fowler's position as often as possible D. Administering oxygen via nasal cannula at 2 L/min

Correct Answer is B

Explanation

A. Helping the client select a low-salt diet: While a low-salt diet is important for managing conditions like hypertension and heart failure, it does not directly affect the viscosity of bronchial secretions in COPD.

B. Encouraging the client to drink 2 to 3 L of water daily: Increasing fluid intake helps to thin bronchial secretions, making them easier to expectorate. Adequate hydration is essential for patients with COPD to manage mucus and reduce the risk of respiratory infections.

C. Maintaining a semi-Fowler's position as often as possible: This position can help improve lung expansion and ease breathing but does not specifically help in loosening or thinning bronchial secretions.

D. Administering oxygen via nasal cannula at 2 L/min: Oxygen therapy is important for maintaining adequate oxygenation in COPD patients but does not address the issue of tenacious secretions directly.

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A nurse is caring for a client who has Cushing's syndrome. Which of the following interventions should the nurse expect to perform? (Select all that apply.)

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